림프절, 피부, 뇌를 침범한 파종성 콕시디오이데스진균증 1예

A Case of Disseminated Coccidioidomycosis Involving the Lymph Nodes, the Skin, and the Brain

저자들은 미국 애리조나에서 거주력이 있는 건강하고 젊은 한국인에게서 림프절, 피부, 뇌를 침범한 파종성 콕시디오이데스진균증을 확인하였기에 이를 문헌고찰과 함께 보고하는 바이다.

Coccidioidomycosis, a fungal infection caused by the fungus known as Coccidioides immitis, can affect many species of mammals and some reptiles. The fungus is endemic in the soil of the southwestern United States, Mexico, and parts of Central and South America. Most infections in humans are relatively mild or asymptomatic, but severe or fatal illness can also occur, especially in the elderly or immunocompromised. We report on a patient with disseminated coccidioidomycosis whose lymph nodes, skin, and especially brain were infected at diagnosis; however, the lung parenchyme was not infected. Because the brain infection could have been a fatal complication in this peculiar case, we recommended life-long fluconazole treatment for the patient. After 2 months of high doses of fluconazole, the patient's clinical signs were greatly improved with respect to fever, headache, skin lesions, and mediastinal widening on the chest X-ray.